Morning of the Stem Cell Revolution

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christian.jpgImagine a day when patients suffering from tuberculosis could go down to a hospital and trade in their diseased windpipes for a brand-spanking-new model custom built from their own cells and live free of the disease.  Or where parents of congenitally brain damaged children could purchase a blood transfusion cocktail that would unlock the world of mental normality for their beloved children.  Or where heart-attack victims could receive cardiac injections of miracle cells that not only would heal their damaged heart muscle, but also stimulate new blood vessel growth in their hearts and reduce scar tissue from the injury?  Say ‘good morning’ to the stem cell revolution because that day has begun.  I should be more precise: the ADULT stem cell revolution HAS BEGUN.  Remarkably, these are not the dreams of some distant future but the treatments and possibilities opening before us right now.

Last March, the left lung of 30-year old Columbian woman, Claudia Castillo, collapsed as a result of the advanced tuberculosis with which she had suffered for years.  Barely able to breath, she decided to undergo an experimental windpipe transplant in Barcelona. A section of windpipe was taken from a deceased donor.  Physicians at the University of Padua in Italy scoured the pipe for six weeks with detergents and enzymes to eliminate all donor cells, leaving behind a bare scaffold of human connective tissue.  Taking precious bone marrow (adult) stem-cells from Castillo’s hip, a research team from the University of Bristol, England, coaxed the cells to develop into millions of cartilage cells and tissue cells identical to those that coat and line windpipes.  Finally, experts at the University of Milan used a special bioreactor to coat and line the tracheal scaffold with the newly grown cartilage and tissue cells derived from Castillo’s stem cells.  In June in Barcelona, Castillo had her section of irreparably damaged windpipe replaced with a brand-spanking-new windpipe constructed from her own stem-cells, without worry of graft rejection.  Five months later, she is caring again for her two children, taking long walks without growing winded, and even—she reports—dancing the night away at clubs in Barcelona.  There has been no indication thus far of tissue rejection. [1]

Four year old New Zealand girl, Maia Friedlander, suffered brain damage at birth which left her unable to walk and talk properly and even to chew her food without choking.  Three years of constant therapy had little positive effect.  Last August she travelled to Duke University Medical Center in N.C. to receive a cocktail of her own stem cells aimed at correcting her brain injury.  She underwent an infusion of her own umbilical cord blood which her parents had stored for her after birth.  Within days her coordination and mental condition had manifestly improved.  Her father, Daniel, was recently reported as saying: “She’s like a different child – talking, hugging us, playing … She’s had a second chance at life and we can now have the family life we’d always dreamed of.” [2]

Finally, researchers at the University of Pittsburgh School of Medicine transplanted human adult stem cells into the hearts of mice suffering from heart damage similar to the kind of injury suffered by humans in heart attacks.  The stem cells came from a newly derived population taken from human skeletal muscle.  The transplant resulted in the rapid repair of damaged heart tissue, the stimulation of new cardiac blood vessel growth, and the diminishing of scarring from the tissue damage.  The study gives hope that a similar procedure might begin for humans in the near future. [3]

As I said, welcome to the dawn of the stem cell revolution.  Clinical breakthroughs using adult stem cells are literally announced daily.  As the sun rises to high noon, we will see the domain of regenerative transplant medicine become the dominant means for repairing seriously diseased organs.  Damaged tissues and organs of every sort will be replaced by living organs grown in the laboratory from a patient’s own adult stem cells.  The clinical possibilities for good are staggering.

At the same time we are menaced by the far less benign stem cell revolution demanding the lives of human embryos.  Notwithstanding the surfeit of clinical triumphs using adult stem cells (ASCs), and unparalleled possibilities arising from the amazing induced pluripotent stem cells (iPSCs), a majority of stem cell researchers still demand human embryos. 

Parallel to the successes I’ve just noted with ASCs are continuing setbacks for embryonic stem cell research. Two different studies were published at the end of November in the journal Nature Biotech increasing fears that the already known instability of ESCs for tumor formation may be worse than researchers thought.  The studies confirmed that when human embryonic stem cells are cultured in the laboratory, they tend to gain or lose large sections of chromosomes.  Chromosomes carry a person’s DNA—the delicately balanced genetic blueprint for our bodies.  Humans normally have 23 pairs of chromosomes (for a total of 46).  The addition, deletion, increase or decrease of even a single one can cause grave abnormalities (Downs Syndrome, for example, results from the addition of a single chromosome at pair 21).  In examining independently derived stem cell lines, researchers found multiple instances of trisomies (where a pair picks up a third) and monosomies (pairs that have lost a chromosome), as well as amplifications of existing pairs.  In some cases the chromosomal anomalies led to rapid increase of cell growth indicating the dangerous tendency for tumor formation. [4]  In light of this, concerned citizens need to put the following question to scientists who insist on experimenting on human embryos: ASCs have enormous clinical potential; what they lack may be fulfilled by iPSCs; why then continue to create, exploit and destroy human embryos?

A danger for ethically conscientious people when faced with the moral outrages of unscrupulous scientists is to become cynical towards science, or even worse, become anti-science.  This is a grave error.  Science is nothing more than the systematic endeavor to understand God’s creation.  Faith in a God who creates an ordered and intelligible universe, endowing mankind with a small piece of his own understanding, and with an incorrigibly inquisitive spirit, was the virtue that gave birth to modern science.  Unfortunately today many of its dominant voices are evangelists for a godless universe.  But there are still many good Christian scientists today; and many other scientists who are not Christians but who recognize that there are ethical boundaries that science must not transgress.  We must support and encourage them and insist that they be given a seat at the tables of scientific decision making. 

[1] The results were published online on Wednesday November 19, 2008, in the British medical journal, The Lancet.  For report see:
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/the-medical-miracle-1024576.html

[2] The Dominion Post, Wednesday, December 3, 2008, available at http://www.stuff.co.nz/4780241a11.html

[3] The study was published in the Dec. 2, 2008, issue of the Journal of the American College of Cardiology.  For report see: http://www.physorg.com/news146832938.html 

[4] The two studies are: Lefort, N., et al. “Human embryonic stem cells reveal recurrent
genomic instability at 20q11.21,” Nature Biotechnology, Published online: 23
November 2008, doi:10.1038/nbt.1509; Spits, C., et al. “Recurrent chromosomal abnormalities in human embryonic stem cells,” Nature Biotechnology, Published online: 23 November 2008, doi:10.1038/nbt.1510.

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